Deep in the bowels of Schiphol Airport, there sits a fly at the bottom of each urinal. The fly's aim - if you will pardon the pun - is to encourage men to direct their wee into the urinal and not the floor.

According to Klaus Reichardt, who came up with the idea of printing a fly on the porcelain, 'nothing works as effectively as getting men to aim in the right place'.

And it's getting people to do the right thing for their health which lies at the heart of public health campaign messages. What works best? Should we scare people into doing the right thing, persuade them by emphasising the rewards of their behaviour change - or maybe we give them a gentle, non-coercive, non-authoritarian and non-obtrusive nudge towards making the right choice.

It's the theory behind an intervention called Nudge Theory, and it's application in public health campaigns and behaviour change, that we will cover in this blog.

Nudge theory has been around for some time and is founded on behavioural science. The first formulation of the term and associated principles was developed in cybernetics - the scientific study of how humans, animals and machines control and communicate with each other.

The theory first gained prominence in 2008, with the publication of a book called Nudge: Improving Decisions About Health, Wealth, and Happiness by Richard Thaler and Cass Sunstein.

In their book, Thaler and Sunstein describe nudges as 'any aspect of the choice architecture that alters peoples behaviour in a predictable way without forbidding any options or significantly changing their economic incentives. To count as a mere nudge, the intervention must be easy and cheap to avoid.'

Nudge theory encourages and allows people to make the right choices — no compulsion, no bans - no 'nanny-state'. Most of the time you won't even realise it's happening.

Take the fly in the urinal example: There is no sign saying 'don't pee on the floor'. There is no information highlighting the dangers, or how much of a pain it is for airport staff to clean up the mess. Just a small printed fly, sitting at the bottom of the bowl - result - 80% reduction in spillage. Although to be honest, we have no idea how they managed to measure less wee on the floor.

Behavioural Insights Unit

Nudge theory quickly gained a following among politicians and organisations across the globe as a cheap and fast way to change behaviour.

In 2009, then-US president Barack Obama made Sunstein the head of The Office of Information and Regulatory Affairs, charged with using nudges to improve regulations.

In 2010 David Cameron set up a Behavioural Insights Unit (BIT) to promote nudges. Other countries, including Canada, Germany, and Qatar, set up similar initiatives.

Companies like General Motors (GM) took the lesson of Nudge seriously. For years, GM invited women to join its employee resources group, GM Women, when they joined the company. Now the GM enrols them automatically, requiring the women to opt-out if they don't want to belong, which has led to increased involvement in GM women.

At the core of Nudge Theory lies a philosophy called Libertarian Paternalism.

What is Libertarian Paternalism?

The Libertarian bit of Libertarian Paternalism starts with the premise that people should be free to choose, to do what they like, have freedom of choice. The Paternalism bit suggests that it is OK for Governments and organisations to nudge people into making decisions that will improve their lives and health.

People don't always make the right decisions, the ones that will improve our health and help us eat healthier, take more exercise. We all lead busy lives and don't always have the information or opportunity to make those choices. Sometimes it is just easier to make a familiar choice, the one that is in front of us, the one we are familiar with.

Libertarian Paternalism claims it can help us make them without being bossy and opinionated. A nudge doesn't ban or block anything; it doesn't cost us anything if we ignore it; there are no sanctions for ignoring it. If you want to continue eating food that is bad for your health and makes you obese - go for it.

But choice architects can try to nudge us into making the correct choices. Putting the healthiest food at eye level and within reach while leaving the cheese and onion pasties on the bottom shelf would count as a nudge - banning cheese and onion pasties wouldn't.

What is choice architecture?

Choice architecture is all around us. It influences the way things are presented to us. Changing these presentations can help us make better choices.

Supermarkets use choice architecture to control the way we move around their stores. They group items and special offers to encourage us to buy things we may not otherwise buy.

Listing the calorie count and percentage of fats and sugars on food products are nudges. They don't ban food that contains lots of fat or sugars, or make their purchase difficult; there is no penalty for not choosing the healthiest option (apart from your waistline). They merely provide information and leave us to make a choice - we decide whether to act on the information.

Examples of choice architecture

The fly in the urinal at Schiphol Airport we mentioned at the beginning of this blog is probably one of the most well-known examples of choice architecture because it appeared in Thaler and Sunstein's book. But let's look at some other cases of how the effective use of choice architecture can nudge us into making the right decisions.

Nudges for attending Doctor's appointments

The Knowledge Centre at the University of Warick experimented to see if they could reduce the number of missed GP appointments.

They conducted two randomised controlled trials testing the impact of a re-worded reminder on 'Did Not Attend' (DNA) rates.

In an initial trial of 10,000 patients, a reminder text message, sent in advance, that highlighted the cost of a missed appointment to the health system produced a DNA rate of 8.4 per cent, compared to 11.1 per cent for the existing message.

A simple tweak to a message made a significant saving to already stretched budgets.

Nudges for organ donation

Countries which have an opt-in system for organ donation may have donation rates as low as 15%. Countries who have organ donation as a yes default option can see rates reaching upwards of 80%.

Nudges for Road Safety

Drivers may have noticed a series of lines on the road as they approach dangerous sections. The stripes gradually become closer together, giving the illusion that you are driving faster as you approach a hazardous bend or junction. There are no speed bumps, no speed cameras - just a series of decreasing lines, nudging you to touch the brake.

Nudges for paying your taxes

The UK Government behavioural insight team, or the nudges unit, as it became known added a line of text to tax reminders which reminded people that most people in their area had already paid their taxes. The result was a 15% increase in payment rates: no threats, no coercion, just a gentle nudge.

Nudges for reducing alcohol consumption

A group of student who drank excessively were sent a series of text message which ranked their drinking in comparison to their peers.

The message that told them they were in the top 10% of the heaviest drinkers led to half the excessive drinkers requesting more information about alcohol.

Only 5% from the group, who received the message comparing their drinking to official guidelines, asked for more alcohol advice.

The sample size for this test was small, but it does suggest that reframing the message, and setting it in a different context can improve its effectiveness.

Nudges for reducing the consumption of sugary drinks

A recent study, by a well-known fast-food restaurant, explored if you can influence which soft drink consumers select on a touchscreen kiosk, just by changing the order of the drinks. In the current study, the Coca-Cola icon was moved from the first to last location and the Coke Zero icon from the third to first.

The intervention decreased the number of times Coca-Cola was sold and increased the number of times Coke Zero (sugar-free) was sold. The result highlights how choice architecture helps modify real-world behaviour.

Using nudge theory in healthcare

With decreasing NHS budgets and increasing pressure on resources, it's no surprise that Nudge Theory has become popular amongst politicians and healthcare organisations.

Nudges can have a positive cost-benefit consequence. Small changes that don't require costly interventions and enforcement can, and have, played a role in improving health behaviours and outcomes.

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This blog content guide was originally written for a client, called Laughology, a London-based learning and development organisation, who retain us to work on website design, content creation, and creative digital marketing.

Although they are based in London, they have a number of trainers and consultants based throughout the UK, all of whom will be creating website and blog content with the goal of increasing visitors, and converting them into clients

This guide helped them understand why and how we add fresh content to the website, how that content should be structured, and the correct tone and style to use. It is relevant to all content creators.

These blog style tips and techniques will help you to increase the visibility of Laughology blogs in search engine results and make them more relevant to readers.

Why we add blog content to the website

A website that regularly posts well written and relevant content/blogs will increase its ranking on search engines and increase visitors to the site. The blogs will:

• Demonstrate knowledge
• Build trust with existing and potential clients
• Increase trainer bookings

What should the reader get from a blog?

Think of a blog as a kind of L&D Haynes manual - but hopefully a bit more entertaining and dynamic. They should be a 'how to' for the workplace. Blogs should identify a need/problem/issue, and show how to overcome them by explaining: what to do, how to do it, and why.

What should we write about in a blog?

Think about what's current and topical, within Laughology and the broader world of work. What's in the news, what are others blogging about, are there new L&D innovations clients should know about? Listen to what clients are telling you about issues they are having in their workplaces, what they are trying to change and improve. In those conversations, emails and training needs forms, will be clues to possible blogs subjects.

If a client explains that redundancies are looming, maybe a blog about having difficult conversations may be useful. A comment about the high turnover of staff or high absenteeism could suggest a blog about motivation or resilience. You're the L&D experts - what's exciting and relevant to your potential and existing clients?

Research your blog subject

We have recently been discussing having difficult conversation as a blog subject, so let's go with that as an example for a blog. Before you write it, spend a few minutes researching the subject and finding out what question people are searching for.

A search using Google in the Chrome browser, for the search term 'having difficult conversations at work' shows a list of related questions people have been asking. You can see these in the 'people also ask' box at the top end of the search results.

Examples of 'people also ask', are:

• How do you have difficult conversations with employees?
• How do you have difficult conversations with clients?
• How do you have difficult conversations when you don't like conflict?
• How do you start an uncomfortable conversation?
• How do you have difficult conversations with your partner?
• How do you handle an employee with a bad attitude?
• How do you start a conversation with a difficult person?
• How do you mentally prepare for a difficult conversation?
• How do you have a difficult conversation with your boss?

In the 'Searches related to having difficult conversations at work' list, at the bottom of Google Chrome, suggested other questions people have been asking, such as:

• managing difficult conversations ppt
• having difficult conversations with employees training
• difficult conversation preparation worksheet
• difficult conversations training course
• difficult conversations training activities
• how to have a difficult conversation with your boss
• having difficult conversations with clients
• having difficult conversations with parents

If you want to get really granular and do some further keyword research, there are many tools you can use. Google has its own keyword tool. One of our favourites is the MOZ keyword tool. You will have to pay for the privilege, but it comes with lots of other juicy SEO features

This keyword research should be your starting point for possible titles, subtitles and sections of your blog. Remember, search engines will only show your content if it contains the language and reflects the intent of the searcher.

It's important to consider who your blog is written for. The language you use for a headteacher blog may be different than the language you use for teachers. The technical L&D language you can use with HR professionals may not work so well with other sectors of the workforce, or indeed between different industries. Know your audience.

Remember that not everyone will use technical L&D language when looking for solutions online. I would be surprised if many people sat down and searched for 'how do I create a resilient and engaged workforce', they are more likely to search for the results of not having a resilient and engaged workforce, so it's important to reflect that. It's up to the author to identify that language and reflect it in the blog.

Blog style and tone of voice

The blogs should offer solutions to problems and practical advice in a punchy and dynamic style which reflects the personality of the author and Laughology - a weird mixture of Stephen Fry and Sandi Toksvig I believe the last team meeting decided best reflected the organisation?

Blogs are ultimately designed to sell Laughology, but they don't need to shout about what we do or how good we are. The blog content should prove that. They need to sound friendly and useful - not selly. If you include a phrase or word related to a Laughology workshop or programme, we will create a link to it.

We want the blog to reflect the personality of Laughology and the author, but we don't need too much autobiography unless it supports the 'what, how and why.

It's important to remember that blogs should be written for humans and optimised for search engines. It's easy to forget that when trying to optimise content for search engines.

How should a blog be structured?

Blog title

The title is one of the most important clue search engines have to help them guess what the content is about. A relevant, engaging title will also encourage humans to click your blog ahead of all the other search results.

If the blog is about difficult conversations use that key phrase in the title - the rest is up to you - it can still be witty and engaging.

The title is also the most prominent part of social media posts - a good one will increase clicks and engagement.

Keep the important part of the title in the first 60 characters. Most titles will be cut off in search results after that length - at least on desktop searches.

Google typically displays the first 50–60 characters of a title tag. If you keep your titles under 60 characters, you can expect about 90% of your titles to display properly.

On some mobile devices, you may get more of the title showing. Feel free to make it longer but be aware it may not all show on some devices.

Introduction/first paragraph

Make sure the first para or two explains the subject of the blog.

Repeat the key phrase, but don't overuse it. Otherwise, your writing can become a bit wooden. Introduce related terms and words - don't overthink these - they will generally flow as a natural part of your writing

The title and first couple of paras should make it clear to readers and search engines exactly what the blog is about and what they will learn if they read on.

Have a look at this blog by Forbes. It is a good example of blog structure, and how to use titles and subheads. 

How many words should a blog be?

There are no rules; short blogs can rank quite well if they provide value to the reader. But if you clicked on a link from the hundreds of emails you get every day, and the blog was only three or four paras long you may feel you have wasted your time - unless it was a piece of scintillating writing. Use as many words as you need, to say what you need to say, I would say circa 1000 was a decent average.

Readability

Break your copy down into short paras and use subheadings, lists and bullet points. You don't scan copy on screen the same way you do in print. On a screen, you scroll the words up past your eyes, and when reading print, you move your eyes down the page. It is much easier to navigate if the text is broken up - particularly on mobile devices.

On wider screens, it can sometimes be difficult to find the beginning of the next line. Visual clues like spaces and heading will make it a more comfortable read.

So, short paragraphs and subtitles. Make the subtitles relevant. Search engines will use the blog title and subheadings to determine what the subject of the blog is.

Keep the blog focused on 2 or 3 related subjects. Try not to write a couple of generic paragraphs, add a load of bullet points and then finish with a final generic paragraph. Better to focus, reduce the list and explain each point in a bit more detail - it will give you more opportunity to show your knowledge and expertise.

You can find some interesting info about readability on the MOZ website.

Blog summary

• Identify a need/problem/issue
• Do your research on what people are searching for
• Stay focused on related topics
• Offer practical solutions people can use in work situations
• Try to avoid long lists
• Use fewer bullet points and offer more explanation
• Use relevant titles and subheads for the subject and audience
• Break copy up into compact paragraphs
• Don't try to sell or be autobiographical

Remember, blogs should identify a need/problem/issue, and show how to overcome them by explaining: what to do, how to do it, and why.

Happy blogging!

Many interesting social marketing projects snake their way through the Substance studio, most of which we have a reasonable working knowledge of - but ACE's were a new one on us. This blog will take you from ACE ignorance through the research, design and production of an ACE animation.

When Andrew Bennet, a public health consultant, approached us about working on an awareness campaign about ACEs, commissioned by Public Health Wales and Blackburn and Darwen Council - we had to admit - we had no idea what the client was talking about. So time to fire up the search engines and log in to youtube.

Scoping out and researching a subject online can sometimes be tedious - there are only so many graphs, tables and contradictory opinions you can take before you start yearning for the halcyon days of a trip to the local reference library. But bear with us, the theory behind ACEs is interesting and some of the work being done around them is fascinating.

What are ACE's, and what did we find out?

ACE's is an acronym for Adverse Childhood Experiences. During the mid to late 90s Kaiser Permanente, a health care consortium in America, conducted the first study into ACEs. It was groundbreaking research that looked at how ten types of childhood trauma affected long-term health.

Traumas included: physical, emotional and sexual abuse; physical and emotional neglect; living with a family member who’s addicted to alcohol or other substances, or who’s depressed or has other mental illnesses; experiencing parental divorce or separation; having a family member who’s in jail, and witnessing a parent being abused.

How do ACEs affect the physical and mental health of children?

It's important to realise that learning how to cope with adversity and stress is an integral part of healthy childhood development.

When threatened and in a stressed state, our bodies prepare us to respond by increasing our heart rate, blood pressure, and stress hormones, such as cortisol. When this happens within an environment of a supportive relationship with adults, these physiological effects are mitigated and brought back down to baseline. The result is the development of healthy stress response systems.

However, if the stress response is extreme, repeated and long-lasting, and those relationships are unavailable to the child, the result can be damaged, vulnerable systems and brain architecture, which can cause lifelong damage.

The scientific explanation of how early adversity affects brain architecture is way above our pay grade, but there is an interesting article in Psychology Today if neural pruning and epigenetic shifts are your thing.

Repeated ACEs cause chronic ill health in later life: like cancer, heart disease, diabetes, and health-harming behaviours such as problem alcohol use, smoking, poor diets and violent behaviour - and ultimately premature death.

A recent study from our client, Public Health Wales, on adverse childhood experiences and their impact on the Welsh adult population, has found that people who reported experiencing four or more ACES are:

• 4 x more likely to be a high-risk drinker
• 6 x times more likely to have had or caused unintended teenage pregnancy
• 6 x times more likely to smoke e-cigarettes or tobacco
• 6 x times more likely to have had sex under the age of 16 years
• 11 x times more likely to have smoked cannabis
• 14 x times more likely to have been a victim of violence over the last 12 months
• 15 x times more likely to have committed violence against another person in the last 12 months
• 16 x times more likely to have used crack cocaine or heroin
• 20 x times more likely to have been incarcerated at any point in their lifetime

Further research suggested ACEs can be passed across the generations, which reminded of the saying about apples not falling far from the tree - got to love the old granny wisdom.

Admittedly the outlook may look pretty grim. A positive message about ACEs - how are we going to do that? But all is not lost. Studies form Public Health Wales and Bangor University suggested that supportive adult relationships and early interventions can help to reduce the damaging effects of ACEs.

The Welsh Adverse Childhood Experience (ACE) and Resilience Survey by Bangor University and Public Health Wales says that while teaching children to be resilient 'does not entirely counter the risks associated with exposure to multiple ACEs', a combination of 'high resilience and low ACEs provided the lowest risks of a lifetime and current mental illness'. It went on to say that 'focus should continue to be placed on strengthening early years, parenting and family programmes', and that these 'programmes can both reduce ACEs and support the development of resilience in children.'

ACEs - target audience and core message

A clear message, communicated to the correct audience is vital to encouraging behaviour change. It was clear from the research that early intervention was one of the most effective tools in preventing or mitigating the damaging effects of ACEs.

It followed that the target audience should be people and organisations who came into contact with young children and families, could identify problems in an early-years setting and be able to use resources to stage interventions.

The audience could include health visitors, social care services, teachers, GPs, midwives and police - amongst others. The message we eventually used - 'We all need to be ACE aware' - had practically written itself.

To deliver this message and navigate our way through a sometimes complex set of circumstances, we needed to raise awareness with this clear and accurate message, followed by a call-to-action which could help provides a solution.

Creating the ACEs animation

It was quite an emotional process, researching the impact of ACEs - particularly as a parent: did you always do the right thing with your children; could you have dealt with things better; did you protect them enough.

Deploying those emotions and using them to tell a story is a powerful tool at any level of marketing, be it commercial or social. To leverage the emotional connection with the audience, we created 'ACE's boy' and used him to narrate the various stages of his life and how ACEs had affected him.

In the first scene, he is introduced as a young child and explains his early struggle with ACEs and how they are affecting him.

Scene 2 shows him as a teenager - again in the first person, as he explains to us how ACEs have changed him.

In Scene 3 the teenager has become an adult and is starting to display the impact of ACEs. He explains how his life has gone and how he expects it to be in the future.

In scene 4 there is a twist - we all love a good twist in the storyline don't we. But we won't spoil it for you; watch the animation and find out for yourself.

The final scene. Although this is the shortest scene, it is arguably the most important - the 'Call to Action'. It speaks directly to the core audience, summarises the main message and through a combination of prodding, cajoling, nudging and being ACE aware it will provoke a positive response from your intended audience.

That's it from us. Hope you enjoyed the blog and found it informative. Take a few minutes to have a look at the animation. If you have any questions, please feel free to This email address is being protected from spambots. You need JavaScript enabled to view it..

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ACES_ANIMATION_FINAL_EL_SUB_FULL from www.substance.org.uk on Vimeo.

Home to a heady mix of opinionated ranting, vented spleens, and occasionally interesting stuff.

Can peeing on the floor improve public health behaviours?

Encouraging positive public health behaviour change

ACE’s, early years & interventions

Creative animation

How to write a blog for maximum SEO

Digital marketing